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Diabetes therapy via videoconference viable method for adolescents
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Adolescents with poorly controlled type 1 diabetes can reap the benefits of behavioral family systems therapy whether conducted in-person or via videoconference, according to research in Diabetes Care.
In a study comparing two methods of delivering behavioral family systems therapy for diabetes (BFST-D) — completed in-person or via videoconference, such as Skype — researchers found similar improvements in adherence to the diabetes treatment regimen and glycemic control.
“The findings from this study don’t imply that practicing clinicians should deliver BFST-D only over videoconferencing,” Michael A. Harris, PhD, chief of psychology at Oregon Health & Science University, told Endocrine Today. “But instead our findings from this study suggest that, for families who live more remotely from a tertiary care center, BFST-D videoconferencing sessions can augment face-to-face clinic sessions and result in improvements in adherence and glycemic control.”
Harris and colleagues analyzed data from 90 adolescents aged 12 to 19 years (mean age, 15.04 years; 55% male; 88% white) with type 1 diabetes for a least 1 year who had suboptimal glycemic control during a period of 7 months. Within the cohort, 46 participants were assigned to BFST-D via Skype and 44 participants were assigned to BFST-D in a clinical setting. All participants received up to 10 sessions within a 12-week period that lasted up to 1.5 hours. All participants continued their regular care with their diabetes care provider during the study period. Researchers measured glycemic control and adherence to therapy 4 weeks before the first treatment session, 4 weeks after the last session and at follow-up 3 months after treatment concluded. Participants received compensation for their time and effort.
Researchers found the method of therapy did not affect participants’ glycemic control or adherence to diabetes treatment. Participants in the Skype group attended an average of 5.84 sessions; in-person participants attended an average of 6.82 sessions. However, there was a higher dropout rate (P < .001) among participants in the Skype group (n = 17) vs. the in-person group (n = 9).
“Importantly, parents and youth reported strong working alliances regardless of whether they received BFST-D via the clinic or videoconferencing,” the researchers wrote. “As such, videoconferencing seems to be an effective and acceptable method for delivering this treatment.”
More research on videoconferencing as a therapy tool is needed to understand potential obstacles, Harris said, including Medicaid or commercial insurance coverage of tele-mental health care, Internet access and security, and the impact on the relationship between clinician and patient.
“Some may be concerned about the impact that videoconferencing has on the quality of the ‘therapeutic relationship’ between the patient, family and psychologist, as there is research to support that the therapeutic relationship is a strong predictor of the outcome of treatment,” Harris said. “Our group has published findings from this study demonstrating that the therapeutic relationship was similar between clinic-based BFST-D and videoconferencing-based BFST-D as reported by the youth with type 1 diabetes and their parents. However, more research on the use of videoconferencing in the delivery of behavioral health to youth with diabetes is warranted to further understand both the benefits and obstacles.” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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